A 24 year old male student presented to the Casualty Department with a 2 day
history of progressive chest pain radiating from the lower left sternal border
to the left axilla.

He was observed to be dyspnaeic and had a slight cough. The student was fully concious but visibly distressed. On examination his pulse rate was 100/min , his breathing was shallow and rapid. He was not cyanosed. Breath sounds were absent on the left and percussion was dull at the left base.

Chest X-Rays were taken one in the P-A view and the other in the
lateral view. The chest X-Ray showed a large opacity in the base of the left
lung with an upper horizontal fluid-air level. This upper zone was devoid of
any lung markings except for a region of collapsed lung medially.